From eating disorder to suicide

The development of an obsessive view with respect to body image to the exclusion of all else can lead to the development of eating disorders and in worst case - death.

Myra was a cheerful outgoing mother of two. At forty two, she had been warned about her excess weight and advised to reduce. She smiled at the doctor and promised to start healthier habits. Of late, she has started hating her body more than ever. Her trim and fit husband avoided having her along for his business parties and the children were embarrassed with her appearance at the parent-teacher interactions. Being 35 kilograms overweight had led to joint pain, difficulty in sleeping and a continuous difficulty in breathing. She tried to start walking but her knees gave way and her back groaned. Her half-hearted efforts to lose weight had come to naught.

Her favorite comfort food – fries. She has been unhappy with her weight for long but it was difficult to see her loved ones viewing her with the disgust she viewed herself with. Her cheerful countenance and advice to others at the centre belied her feelings of inadequacy and loneliness.

She spoke to her husband as he responded with little involvement about her plan to lose weight. This time, she was serious. She made lifestyle changes necessary to reach her goal – her family was going to be proud of her. Snack items were banished from the kitchen (as a magazine had advised) and food portions curtailed to a quarter of the original. Fats were completely banned. Her family did not take her seriously and continued to bandy her favorite snack items and offering them to her. She was soon sneaking small snacks into the house. She gained weight and obsessed about it even more. She could never say when it happened that she started to binge and silently throw it up later. It was the perfect remedy. She was having her cake and eating it too.

After continuous disappointment on the scale, Myra started losing weight, rapidly. She was overwhelmed, she had hit upon the right method. Within less than a year, she had reduced 30 kilograms. She maintained a happy exterior but an unexplained sadness had overtaken her senses. She was increasingly confused and disoriented. She cried a lot over nothing. She started losing interest in the children’s activities, though she maintained she loved them. She had expected to lose weight and feel cheerful, but this was just the opposite. With time, smiling became a chore. Her 10-year old daughter who loved her mother to bits often reported that ‘Mummy was crying in the bathroom,’ to her father. Earlier, Myra used to look forward to the moment her children returned from school. She would make them snacks and listen to all the stories about their day at school. Of late, she has opened the door for them and lay down after they entered the house. She would lie in bed listlessly while her kids trooped into her room and regaled her with stories. Her son had been selected for the soccer team, her daughter was in a play, she has tried to smile, but given up.

Myra’s husband, indifferent at first, started observing his wife. The weight loss wasn’t doing her beauty much good. Her facial skin was sagging and wrinkled. At least she seemed to be reaching a healthy weight. She seemed to need a lot of sleep and her desire for neatness seemed to have reduced drastically. He had heard her retching in the bathroom a few times but she always passed it off as a minor stomach upset. She seemed to miss meals and was often quiet, trying to get her chores done for the day. Everything was okay, he returned to a state of mild indifference. Physical relations between Myra and her husband were at an all time low. Communication has completely stopped, even the short ‘how was your day’ lies ignored. He has been stressed because of work while she…

Due to insomnia, he had opted to use sleeping pills. They led to difficulty in waking; he stopped using them and left them in the drawer.

One morning, Myra did not wake up. Her husband checked her forehead, no fever. Her daughter ran in and hugged her goodbye before leaving for school; Myra did not open her eyes. Her 12-year old son came and kissed her forehead, she did not respond. He asked his father, ‘Is Mummy taking some sleep medicine?’

Startled, her husband rushed to the drawer where his pills had been kept. The bottle was empty.

Myra had overdosed on sleeping pills. She was rushed to the hospital and saved in the nick of time. Surely it had been a mistake, her husband justified. It had been dark, she tipped the pills into her mouth and by mistake, more than one had been consumed, she explained. The medical practitioners were not convinced.

She was visibly distressed by the injections being administered. ‘Please you have stop all these medicines; I don’t want to put on weight again,’ she explained. She fretted about the calorific value of the medicines that were being forced into her body.

When her daughter and son visited, the girl snuggled up to her and asked, ‘Mummy, you won’t die and go, right?’ Her son watched her from a little distance. Myra looked at her, vaguely comprehending but not responding. The girl’s chin trembled as she looked to her mother for succor. Myra was weeping again. She did not understand her feelings or lack of them. She cared but felt strangely empty. She understood her daughter’s distress but did not feel moved to reduce it. Her son’s confused silence would normally have pained her, now she felt nothing. She wished she could feel…

What is the problem?

Understand the brain

Schmidt (2006, p. 15) describes the brain as being largely made up of fats, ‘especially fatty acids which we get directly from our food.’ The author describes the brain as a network of ‘nerve fibers that hard-wire one area to another, branches that connect diverse regions and junctions that allow for communication.’ The nerve cells possess a membrane that consists of fat. Complex bodily functions require speedy transmission of nerve impulses. This is made possible by myelin, a mix of fats, fatty acids, cholesterol, phospholipids and protein. All these components must come from the diet since the body cannot produce on its own.

Bulimia

When a family member embarks on a weight loss program, family support includes being aware of mood disturbances or behavioral changes. The development of an obsessive view with respect to body image to the exclusion of all else can lead to the development of poor habits that seem to serve the purpose. The loss of nutrition due to voluntary expulsion after consumption is an eating disorder and has long been recognized as putting people at an increased risk of suicide. Tatarelli, Pompili and Girardi (2007, p. 155) quote the observation of Orbach that ‘dissatisfaction with the body can increase suffering and intensify self-destructive tendencies.’ Bulimia is explained by Watson (2007, p. 6) as a ‘type of eating disorder in which a person binges and purges.’ This disorder has numerous physical and mental health implications.

Depression

Depression is a disorder of the mood that may pass on or stay to convert into a severely disabling condition. Ainsworth describes the condition as being like a thief that sneaks into a ‘life gradually, robbing it of meaning, one loss at a time.’ Myra requires psychiatric help and a study of the various factors that are causing her spiral into depression and possible suicide. The connection between food, the state of mind and suicide must be clearly understood when undertaking a body shape correction. Myra’s extreme food deprivation has led to cognitive difficulties and makes the likelihood of grievous mistakes recurring in the future.

Schmidt (2006, p. 145) opines that there is a connection between fat consumption and depression. ‘Elevated blood cholesterol and triglycerides’ cause the blood to thicken and slow oxygen supply to the brain and create conditions like depression and other disorders. The author refers to an old book that recommends a diet prescription for depression ‘low-fat diet, borage oil and consumption of fish. For severe cases… cow brains.’ Myra has been on an all-food binge and purge diet and this has led to physical and mental disarray. The attitude of the husband towards his wife and underlying depressive factors requires immediate attention.

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